An analysis of the demand for primary care physicians in the Hinton, Oklahoma, medical service area

An Analysis of the Demand for Primary Care
Physicians in the Hinton, Oklahoma,
Medical Service Area
Rural Development
Oklahoma Cooperative Extension Service
Oklahoma State University
Oklahoma Office of Rural Health
Rural Health Policy & Research Center
Oklahoma State University
March 2010
AE-10004
An Analysis of the Demand for Primary Care Physicians
in the Hinton, Oklahoma, Medical Service Area
Brian E. Whitacre, Assistant Professor and Extension Economist, OSU, Stillwater
405-744-6083; FAX 405-744-9835
Lara Brooks, Assistant Extension State Specialist, OSU, Stillwater
405-744-6083
Gerald A. Doeksen, Regents Professor and Extension Economist, OSU, Stillwater
405-744-6083
David Nowlin - Caddo County Extension Director, Anadarko
(580) 247-3376
Stan Ralstin - District Rural Development Specialist, Enid
(580) 237-7677
Corie Kaiser, Health Consultant, Oklahoma Center for Rural Health, Oklahoma City
405-945-9197
Val Schott - Director, Oklahoma Center for Rural Health, Oklahoma City
405-945-9197
Rural Development
Oklahoma Cooperative Extension Service
Oklahoma State University
Oklahoma Office of Rural Health
Center for Rural Health
Oklahoma State University
March 2010
1
An Analysis of the Demand for Primary Care Physicians
in the Hinton, Oklahoma, Medical Service Area
Introduction
This report will examine the need for primary care physicians in the Hinton, Oklahoma,
Medical Service Area. Primary care physicians include internal medicine physicians, family
practitioners, obstetrics-gynecologists, and pediatricians. Specifically, the study will:
1. Determine the medical service area and population;
2. Estimate primary care physician office visits; and
3. Estimate the total demand for primary care physicians in the medical service area.
No recommendations will be made. The information included in this report is designed to assist
local decision-makers in assessing the need and potential for primary care physician services.
Determining Need for Primary Care Physicians
in the Hinton, Oklahoma, Medical Service Area
In order to estimate the number of visits to primary care physicians in Hinton, the
medical service area was delineated as shown in Figure 1. To determine the medical service
area, a number of factors were taken into consideration, including the proximity of physician
practices in nearby cities and the travel distances faced by residents of nearby communities. In
particular, existing physician practices in the surrounding communities, Anadarko, Carnegie,
Watonga, El Reno, Weatherford, Chickasha, and Kingfisher likely draw residents of those
nearby communities. Therefore, the primary medical service area for Hinton includes Hinton
and Lookeba while the secondary medical service area is comprised of Geary, Calumet, Binger,
and Hydro, since there is the possibility that some individuals in these towns will choose to go to
Hinton for their physician needs. The 2009 estimated population of the primary medical service
2
area was 3,774 as shown in Table 1. The 2009 estimated secondary medical area population
totals to 8,217. This yields a total population of 11,991 for both the primary and secondary
service areas.
Hospital County
Number of
Beds
Watonga Municipal Hospital Blaine 25
The Physicians' Hospital in Anadarko Caddo 25
Carnegie Tri-County Municipal Hospital Caddo 21
Parkview Hospital Canadian 48
Weatherford Regional Hospital Custer 25
Grady Memorial Hospital Grady 99
Kingfisher Regional Hospital Kingfisher 25
Cordell Municipal Hospital Washita 25
Figure 1
Hinton, Oklahoma Medical Service Area
Primary Service Area Secondary Service Area
3
Table 1
Hinton, Oklahoma Medical Service Area Population by
Zip Code
Estimated 2009
Population Totals
Primary Medical Service Area
73047, Hinton 3,070
73053, Lookeba 704
3,774
Secondary Medical Service Area
73009, Binger 1,862
73014, Calumet 2,354
73040, Geary 1,820
73048, Hydro 2,181
8,217
Medical Service Area
Total 11,991
Source: ESRI 2009 Community Sourcebook of Zip Code
Demographics, 23rd ed., ESRI Business Solutions
The number of physician office visits generated in the Hinton, Oklahoma service area
was estimated using the service area population data and research on the number of annual
physician office visits for a specified age group [1, 2, 3]. Age group breakouts (by gender) and
their corresponding number of annual physician office visits are presented in Table 2. For
instance, for males under age 15, the average number of physician office visits is 2.8 visits per
4
year [3]. Similar estimates are applied to other age groups to derive the total number of
physician office visits occurring in the Hinton medical service area. Residents in the primary
medical service area were estimated to make 12,676 total physician office visits per year, while
residents of the secondary medical service area were estimated to visit physicians 28,646 times
annually (Table 2). Of these total physician office visits, recent data indicates that 58.4 percent
will be made to physicians active in primary patient care while the remainder will be made to
specialists [3]. Using the data presented in Table 2, the primary medical service area will
generate 7,403 primary care physician visits (58.4% x 12,676), and the secondary medical
service area will generate 16,729 visits (58.4% x 28,646) yielding a total of 24,132 local primary
care physician visits per year for the total medical service area.
The total number of primary care physician office visits given various usage rates is
presented in Table 3 for the Hinton medical service area. If there is a 90 percent usage of Hinton
primary care physicians by residents of the primary medical service area and a 20 to 25 percent
usage rate from residents in the secondary service area, an estimated 10,009 to 10,845 primary
care physician office visits will be made annually in the Hinton medical service area. The
national average for the number of annual office visits to each primary care physician is 4,870
[3]. Therefore, Hinton needs an estimated 2.1 primary care physicians at a 90 percent primary
medical service area usage rate coupled with a 20 percent usage rate from the secondary medical
service area (10,009/4,870 = 2.055). By expanding the secondary usage rate to 25 percent, the
need becomes 2.2 total primary care physicians (10,845/4,870 = 2.227). Higher usage levels
would indicate that more physicians could be supported, while lower usage levels would indicate
fewer physicians could be supported. All assumptions and local conditions, including the actual
usage levels in the primary and secondary medical service areas must be taken into consideration
by decision-makers before determining if additional physicians could successfully locate in
5
Hinton, Oklahoma. Note that the current number of existing primary care physicians is not
included in this analysis. Any evaluation of the relative shortage or surplus of primary care
physicians must include details about the current levels of practicing physicians. Again, primary
care physicians include the physician practices of internal medicine, pediatrics, family medicine,
and OB-GYN. All of these types of physicians should be considered when analyzing the usage
levels in the medical service area.
Summary
The analysis above presented the methodology and results of estimating the demand for
primary care physicians in Hinton, Oklahoma. The results suggest that, given a 90% primary
service area usage rate and a 20% secondary service area usage rate, an estimated 2.1 primary care
physicians can be supported in the Hinton area. The actual number of physicians that the Hinton
medical service area can support will vary based on the usage rates depicted in Table 3. Estimates
of these usage rates should be used in conjunction with the current status of the primary care
industry in Hinton to determine the next steps for the community.
Many assumptions have been made in this analysis. These include items that may change,
such as the population of the service area or service area delineation. For example, the service area
depicted here may change due to the exit or entry of physicians from nearby communities. If this
does occur, revised estimates of physician office visits should be made. The number of existing
primary care physicians is not addressed in this study. A close examination of current practicing
primary care physicians will be imperative to accurately assess whether or not the current
population base can in fact support additional primary care physicians.
All assumptions should be closely examined by local decision-makers to verify that they
reflect local conditions. If additional local data are available, they should be included to derive the
6
most realistic conclusion possible for the current situation. If further analysis is needed, contact
your county extension office listed on the title page of this document.
7
Table 2
Annual Primary Care Physician Office Visits Generated in the Hinton, Oklahoma, Medical
Service Areas
PRIMARY MEDICAL SERVICE AREA
Male Female
2008 Visit 2007 Visit Total
Age Population Rate1 Visits Population Rate1 Visits Visits
Under 15 415 2.8 1,163 400 2.5 999 2,163
15-24 245 1.3 319 230 2.2 507 825
25-44 531 1.8 956 480 3.1 1,489 2,445
45-64 456 3.3 1,505 412 4.5 1,854 3,359
65+ 323 6.2 2,000 281 6.7 1,884 3,884
Total 1,971 5,944 1,803 6,733 12,676
Primary Medical Service Area - Local Primary Care Physician Office Visits Per Year:
(58.4% of total office visits)1
7,403
SECONDARY MEDICAL SERVICE AREA
Male Female
2008 Visit 2007 Visit Total
Age Population Rate1 Visits Population Rate1 Visits Visits
Under 15 826 2.8 2,313 795 2.5 1,986 4,299
15-24 510 1.3 663 479 2.2 1,053 1,716
25-44 1,093 1.8 1,968 989 3.1 3,065 5,033
45-64 1,042 3.3 3,438 941 4.5 4,234 7,672
65-74 824 6.2 5,112 719 6.7 4,814 9,926
Total 4,295 13,493 3,922 15,154 28,646
Secondary Medical Service Area - Local Primary Care Physician Office Visits Per
Year: (58.4% of total office visits)1
16,729
1Source: U. S. Department of Health and Human Services, Centers for Disease Control and
Prevention, National Center of Health Statistics, "National Ambulatory Medical Care Survey: 2005
Summary," No. 387, June, 2007
8
Table 3
Primary Care Physician Office Visits Given Usage
By Local Residents in Hinton, Oklahoma Medical Service Areas
Usage by Residents of Primary Service Area
70% 75% 80% 85% 90% 95% 100%
Usage by Residents of Secondary
Service Area
5% 6,019 6,389 6,759 7,129 7,499 7,869 8,239
10% 6,855 7,225 7,595 7,965 8,336 8,706 9,076
15% 7,691 8,062 8,432 8,802 9,172 9,542 9,912
20% 8,528 8,898 9,268 9,638 10,009 10,379 10,749
25% 9,364 9,735 10,105 10,475 10,845 11,215 11,585
30% 10,201 10,571 10,941 11,311 11,682 12,052 12,422
35% 11,037 11,408 11,778 12,148 12,518 12,888 13,258
40% 11,874 12,244 12,614 12,984 13,354 13,725 14,095
45% 12,710 13,080 13,451 13,821 14,191 14,561 14,931
50% 13,547 13,917 14,287 14,657 15,027 15,398 15,768
If 90% primary medical service area and 20 to 25% secondary medical service area, then the usage would be:
10,009 to 10,845 total primary care physician office visits
for an estimated 2.055 to 2.227 Total Primary Care Physicians
Based on 4,870 average annual primary care office visits per physician practice in Oklahoma
9
References
[1] “Family Medicine – A Systematic Approach to the Planning and Development of a
Community Practice,” Doeksen, G., Miller, K.A., Shelton, P.J., and Miller, D.A.,
University of Oklahoma Health Sciences Center, 1990.
[2] "Internal Medicine - A Systematic Approach to the Planning and Development of a
Community Practice - A Step-by-Step Guide," Miller, K.A., Doeksen, G., Miller, D.,
Campbell, J., and Shelton, P.J., University of Oklahoma Health Sciences Center, 1993.
[3] U. S. Department of Health and Human Services, Centers for Disease Control and
Prevention, National Center of Health Statistics, "National Ambulatory Medical Care
Survey: 2005 Summary," No. 387, June, 2007.
[4] ESRI 2009 Community Sourcebook of Zip Code Demographics, 23rd ed., ESRI Business
Solutions.

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An Analysis of the Demand for Primary Care
Physicians in the Hinton, Oklahoma,
Medical Service Area
Rural Development
Oklahoma Cooperative Extension Service
Oklahoma State University
Oklahoma Office of Rural Health
Rural Health Policy & Research Center
Oklahoma State University
March 2010
AE-10004
An Analysis of the Demand for Primary Care Physicians
in the Hinton, Oklahoma, Medical Service Area
Brian E. Whitacre, Assistant Professor and Extension Economist, OSU, Stillwater
405-744-6083; FAX 405-744-9835
Lara Brooks, Assistant Extension State Specialist, OSU, Stillwater
405-744-6083
Gerald A. Doeksen, Regents Professor and Extension Economist, OSU, Stillwater
405-744-6083
David Nowlin - Caddo County Extension Director, Anadarko
(580) 247-3376
Stan Ralstin - District Rural Development Specialist, Enid
(580) 237-7677
Corie Kaiser, Health Consultant, Oklahoma Center for Rural Health, Oklahoma City
405-945-9197
Val Schott - Director, Oklahoma Center for Rural Health, Oklahoma City
405-945-9197
Rural Development
Oklahoma Cooperative Extension Service
Oklahoma State University
Oklahoma Office of Rural Health
Center for Rural Health
Oklahoma State University
March 2010
1
An Analysis of the Demand for Primary Care Physicians
in the Hinton, Oklahoma, Medical Service Area
Introduction
This report will examine the need for primary care physicians in the Hinton, Oklahoma,
Medical Service Area. Primary care physicians include internal medicine physicians, family
practitioners, obstetrics-gynecologists, and pediatricians. Specifically, the study will:
1. Determine the medical service area and population;
2. Estimate primary care physician office visits; and
3. Estimate the total demand for primary care physicians in the medical service area.
No recommendations will be made. The information included in this report is designed to assist
local decision-makers in assessing the need and potential for primary care physician services.
Determining Need for Primary Care Physicians
in the Hinton, Oklahoma, Medical Service Area
In order to estimate the number of visits to primary care physicians in Hinton, the
medical service area was delineated as shown in Figure 1. To determine the medical service
area, a number of factors were taken into consideration, including the proximity of physician
practices in nearby cities and the travel distances faced by residents of nearby communities. In
particular, existing physician practices in the surrounding communities, Anadarko, Carnegie,
Watonga, El Reno, Weatherford, Chickasha, and Kingfisher likely draw residents of those
nearby communities. Therefore, the primary medical service area for Hinton includes Hinton
and Lookeba while the secondary medical service area is comprised of Geary, Calumet, Binger,
and Hydro, since there is the possibility that some individuals in these towns will choose to go to
Hinton for their physician needs. The 2009 estimated population of the primary medical service
2
area was 3,774 as shown in Table 1. The 2009 estimated secondary medical area population
totals to 8,217. This yields a total population of 11,991 for both the primary and secondary
service areas.
Hospital County
Number of
Beds
Watonga Municipal Hospital Blaine 25
The Physicians' Hospital in Anadarko Caddo 25
Carnegie Tri-County Municipal Hospital Caddo 21
Parkview Hospital Canadian 48
Weatherford Regional Hospital Custer 25
Grady Memorial Hospital Grady 99
Kingfisher Regional Hospital Kingfisher 25
Cordell Municipal Hospital Washita 25
Figure 1
Hinton, Oklahoma Medical Service Area
Primary Service Area Secondary Service Area
3
Table 1
Hinton, Oklahoma Medical Service Area Population by
Zip Code
Estimated 2009
Population Totals
Primary Medical Service Area
73047, Hinton 3,070
73053, Lookeba 704
3,774
Secondary Medical Service Area
73009, Binger 1,862
73014, Calumet 2,354
73040, Geary 1,820
73048, Hydro 2,181
8,217
Medical Service Area
Total 11,991
Source: ESRI 2009 Community Sourcebook of Zip Code
Demographics, 23rd ed., ESRI Business Solutions
The number of physician office visits generated in the Hinton, Oklahoma service area
was estimated using the service area population data and research on the number of annual
physician office visits for a specified age group [1, 2, 3]. Age group breakouts (by gender) and
their corresponding number of annual physician office visits are presented in Table 2. For
instance, for males under age 15, the average number of physician office visits is 2.8 visits per
4
year [3]. Similar estimates are applied to other age groups to derive the total number of
physician office visits occurring in the Hinton medical service area. Residents in the primary
medical service area were estimated to make 12,676 total physician office visits per year, while
residents of the secondary medical service area were estimated to visit physicians 28,646 times
annually (Table 2). Of these total physician office visits, recent data indicates that 58.4 percent
will be made to physicians active in primary patient care while the remainder will be made to
specialists [3]. Using the data presented in Table 2, the primary medical service area will
generate 7,403 primary care physician visits (58.4% x 12,676), and the secondary medical
service area will generate 16,729 visits (58.4% x 28,646) yielding a total of 24,132 local primary
care physician visits per year for the total medical service area.
The total number of primary care physician office visits given various usage rates is
presented in Table 3 for the Hinton medical service area. If there is a 90 percent usage of Hinton
primary care physicians by residents of the primary medical service area and a 20 to 25 percent
usage rate from residents in the secondary service area, an estimated 10,009 to 10,845 primary
care physician office visits will be made annually in the Hinton medical service area. The
national average for the number of annual office visits to each primary care physician is 4,870
[3]. Therefore, Hinton needs an estimated 2.1 primary care physicians at a 90 percent primary
medical service area usage rate coupled with a 20 percent usage rate from the secondary medical
service area (10,009/4,870 = 2.055). By expanding the secondary usage rate to 25 percent, the
need becomes 2.2 total primary care physicians (10,845/4,870 = 2.227). Higher usage levels
would indicate that more physicians could be supported, while lower usage levels would indicate
fewer physicians could be supported. All assumptions and local conditions, including the actual
usage levels in the primary and secondary medical service areas must be taken into consideration
by decision-makers before determining if additional physicians could successfully locate in
5
Hinton, Oklahoma. Note that the current number of existing primary care physicians is not
included in this analysis. Any evaluation of the relative shortage or surplus of primary care
physicians must include details about the current levels of practicing physicians. Again, primary
care physicians include the physician practices of internal medicine, pediatrics, family medicine,
and OB-GYN. All of these types of physicians should be considered when analyzing the usage
levels in the medical service area.
Summary
The analysis above presented the methodology and results of estimating the demand for
primary care physicians in Hinton, Oklahoma. The results suggest that, given a 90% primary
service area usage rate and a 20% secondary service area usage rate, an estimated 2.1 primary care
physicians can be supported in the Hinton area. The actual number of physicians that the Hinton
medical service area can support will vary based on the usage rates depicted in Table 3. Estimates
of these usage rates should be used in conjunction with the current status of the primary care
industry in Hinton to determine the next steps for the community.
Many assumptions have been made in this analysis. These include items that may change,
such as the population of the service area or service area delineation. For example, the service area
depicted here may change due to the exit or entry of physicians from nearby communities. If this
does occur, revised estimates of physician office visits should be made. The number of existing
primary care physicians is not addressed in this study. A close examination of current practicing
primary care physicians will be imperative to accurately assess whether or not the current
population base can in fact support additional primary care physicians.
All assumptions should be closely examined by local decision-makers to verify that they
reflect local conditions. If additional local data are available, they should be included to derive the
6
most realistic conclusion possible for the current situation. If further analysis is needed, contact
your county extension office listed on the title page of this document.
7
Table 2
Annual Primary Care Physician Office Visits Generated in the Hinton, Oklahoma, Medical
Service Areas
PRIMARY MEDICAL SERVICE AREA
Male Female
2008 Visit 2007 Visit Total
Age Population Rate1 Visits Population Rate1 Visits Visits
Under 15 415 2.8 1,163 400 2.5 999 2,163
15-24 245 1.3 319 230 2.2 507 825
25-44 531 1.8 956 480 3.1 1,489 2,445
45-64 456 3.3 1,505 412 4.5 1,854 3,359
65+ 323 6.2 2,000 281 6.7 1,884 3,884
Total 1,971 5,944 1,803 6,733 12,676
Primary Medical Service Area - Local Primary Care Physician Office Visits Per Year:
(58.4% of total office visits)1
7,403
SECONDARY MEDICAL SERVICE AREA
Male Female
2008 Visit 2007 Visit Total
Age Population Rate1 Visits Population Rate1 Visits Visits
Under 15 826 2.8 2,313 795 2.5 1,986 4,299
15-24 510 1.3 663 479 2.2 1,053 1,716
25-44 1,093 1.8 1,968 989 3.1 3,065 5,033
45-64 1,042 3.3 3,438 941 4.5 4,234 7,672
65-74 824 6.2 5,112 719 6.7 4,814 9,926
Total 4,295 13,493 3,922 15,154 28,646
Secondary Medical Service Area - Local Primary Care Physician Office Visits Per
Year: (58.4% of total office visits)1
16,729
1Source: U. S. Department of Health and Human Services, Centers for Disease Control and
Prevention, National Center of Health Statistics, "National Ambulatory Medical Care Survey: 2005
Summary," No. 387, June, 2007
8
Table 3
Primary Care Physician Office Visits Given Usage
By Local Residents in Hinton, Oklahoma Medical Service Areas
Usage by Residents of Primary Service Area
70% 75% 80% 85% 90% 95% 100%
Usage by Residents of Secondary
Service Area
5% 6,019 6,389 6,759 7,129 7,499 7,869 8,239
10% 6,855 7,225 7,595 7,965 8,336 8,706 9,076
15% 7,691 8,062 8,432 8,802 9,172 9,542 9,912
20% 8,528 8,898 9,268 9,638 10,009 10,379 10,749
25% 9,364 9,735 10,105 10,475 10,845 11,215 11,585
30% 10,201 10,571 10,941 11,311 11,682 12,052 12,422
35% 11,037 11,408 11,778 12,148 12,518 12,888 13,258
40% 11,874 12,244 12,614 12,984 13,354 13,725 14,095
45% 12,710 13,080 13,451 13,821 14,191 14,561 14,931
50% 13,547 13,917 14,287 14,657 15,027 15,398 15,768
If 90% primary medical service area and 20 to 25% secondary medical service area, then the usage would be:
10,009 to 10,845 total primary care physician office visits
for an estimated 2.055 to 2.227 Total Primary Care Physicians
Based on 4,870 average annual primary care office visits per physician practice in Oklahoma
9
References
[1] “Family Medicine – A Systematic Approach to the Planning and Development of a
Community Practice,” Doeksen, G., Miller, K.A., Shelton, P.J., and Miller, D.A.,
University of Oklahoma Health Sciences Center, 1990.
[2] "Internal Medicine - A Systematic Approach to the Planning and Development of a
Community Practice - A Step-by-Step Guide," Miller, K.A., Doeksen, G., Miller, D.,
Campbell, J., and Shelton, P.J., University of Oklahoma Health Sciences Center, 1993.
[3] U. S. Department of Health and Human Services, Centers for Disease Control and
Prevention, National Center of Health Statistics, "National Ambulatory Medical Care
Survey: 2005 Summary," No. 387, June, 2007.
[4] ESRI 2009 Community Sourcebook of Zip Code Demographics, 23rd ed., ESRI Business
Solutions.